Stunting is a consequence of malnutrition and means being too short for one's age. It is defined as having a "height that is more than two standard deviations below the World Health Organization (WHO) child growth standards median"[1] Around 165 million children under the age of 5 are affected by stunting. According to current projections, 127 million children under 5 will be stunted in 2025. [2]
Studies have shown a clear link between stunting during the first two years of a child’s life and poor cognitive development [3] . On top of this, stunting has a negative effect on a child’s physical development, resulting in smaller head size, poor neuromotor development that manifests as clumsiness and incoordination as well as lack of enthusiasm [4] . It also impacts productive capacity and health, and it increases the risk of degenerative diseases such as diabetes, hypertension and obesity in adults [5][6]
Stunting is widespread in almost all low-income countries and its consequences on health and socio-economic development are severe [7] . As a health statistic stunting is useful for being easy and inexpensive to measure, age- and sex-corrected and comparable across countries [8] .
Stunting and Food
Stunting is a result of inadequate nutrition and repeated infection during a child’s first 1000 days, as well as malnutrition and anemia during the mother’s pregnancy [9][10] . Repeated diarrhea during the first two years of a child’s life is also connected to stunting, as it causes the loss of vital nutrients. When a stunted child reaches the age of two, the stunting can no longer be reversed. Almost half of global child deaths are thought to be caused by stunting and other forms of under-nutrition.[11]
Stunting can be prevented by ensuring that adolescent girls and women before and during pregnancy as well as children under 2 receive adequate nutrition and hygiene [12][13][14] .
Relation to Sustainable Development Goals (SDG)
Stunting is included in SDG 2: “Zero hunger”, and it’s specific target: “By 2030, end all forms of malnutrition, including achieving, by 2025, the internationally agreed targets on stunting and wasting in children under 5 years of age, and address the nutritional needs of adolescent girls, pregnant and lactating women and older persons”.[15]
Illustration of Organizational Praxis
The Maternal and Child Survival Program (MCSP), a global USAID Cooperative Agreement supporting health intervention in 25 countries and with the goal of “ending preventable child and maternal deaths” [16] , works on preventing stunting through research and operations. One of the issues identified by MCSP is junk food consumption at an early age, since this food is commonly poor in nutrients and it is used to replace nutritious food [17] . In Egypt, for instance, a high consumption of junk food has caused both stunting and obesity among young children [18] . MSCP and its predecessor, Mother and Child Health Integrated Program (MCHIP), have conducted operations research around stunting and provided guidance for health providers and community workers to address the issue [19] .
Critique
Stunting is one of many indicators of nutritional status, and it should not be used as the only measurement but rather together with other indicators such as wasting, underweight, mid upper arm circumference or body mass index. When the circumstances that led to a person's stunted growth are known, it is easier to make an accurate assessment of their nutritional status, because stunted growth alone does not tell everything.[20]
Examples from Finland
Stunted growth is uncommon in Finland. When it occurs, the reasons behind it are disruptions at the fetal stage and the health of the mother during pregnancy. On top of poor nutrition, also smoking, heavy use of alcohol and drugs as well as diabetes and blood-pressure problems during pregnancy can cause disruptions in the child’s growth. [21]
^ Mendez, M. and Adair, L. (1999). Severity and Timing of Stunting in the First Two Years of Life Affect Performance on Cognitive Tests in Late Childhood. [online] Jn.nutrition.org. Available at: http://jn.nutrition.org/content/129/8/1555.long [Accessed 8 Feb. 2017].
^ Singh, M. (2004). Role of micronutrients for physical growth and mental development. The Indian Journal of Pediatrics, [online] 71(1), pp.59-62.
^ FAO. (2014). Child and Maternal Nutrition. In: Second International Conference on Nutrition. [online] FAO. Available at: http://www.fao.org/3/a-at521e.pdf [Accessed 8 Feb. 2017].
^ Checkley, W., Buckley, G., Gilman, R., Assis, A., Guerrant, R., Morris, S., Molbak, K., Valentiner-Branth, P., Lanata, C. and Black, R. (2008). Multi-country analysis of the effects of diarrhoea on childhood stunting. International Journal of Epidemiology, [online] 37(4), pp.816-830. Available at: https://academic.oup.com/ije/article/37/4/816/736863/Multi-country-analysis-of-the-effects-of-diarrhoea [Accessed 20 Jun. 2008].
^ FAO. (2014). Child and Maternal Nutrition. In: Second International Conference on Nutrition. [online] FAO. Available at: http://www.fao.org/3/a-at521e.pdf [Accessed 8 Feb. 2017].
^ Wfp.org. (2014). Stunting Steals A Child’s Future | WFP | United Nations World Food Programme - Fighting Hunger Worldwide. [online] Available at: http://www.wfp.org/photos/wfp-and-canada-sudan [Accessed 8 Feb. 2017].
^ United Nations Sustainable Development. (n.d.). Hunger and food security - United Nations Sustainable Development. [online] Available at: http://www.un.org/sustainabledevelopment/hunger/ [Accessed 15 Mar. 2017].
^ Reinhard, I. and Wijeratne, K.B.S., (2000). The use of stunting and wasting as indicators for food insecurity and poverty. Poverty Impact Monitoring Unit. [Accessed 4 May 2017].
Definition
Stunting is a consequence of malnutrition and means being too short for one's age. It is defined as having a "height that is more than two standard deviations below the World Health Organization (WHO) child growth standards median"[1] Around 165 million children under the age of 5 are affected by stunting. According to current projections, 127 million children under 5 will be stunted in 2025. [2]
Studies have shown a clear link between stunting during the first two years of a child’s life and poor cognitive development [3] . On top of this, stunting has a negative effect on a child’s physical development, resulting in smaller head size, poor neuromotor development that manifests as clumsiness and incoordination as well as lack of enthusiasm [4] . It also impacts productive capacity and health, and it increases the risk of degenerative diseases such as diabetes, hypertension and obesity in adults [5] [6]
Stunting is widespread in almost all low-income countries and its consequences on health and socio-economic development are severe [7] . As a health statistic stunting is useful for being easy and inexpensive to measure, age- and sex-corrected and comparable across countries [8] .
Stunting and Food
Stunting is a result of inadequate nutrition and repeated infection during a child’s first 1000 days, as well as malnutrition and anemia during the mother’s pregnancy [9] [10] . Repeated diarrhea during the first two years of a child’s life is also connected to stunting, as it causes the loss of vital nutrients. When a stunted child reaches the age of two, the stunting can no longer be reversed. Almost half of global child deaths are thought to be caused by stunting and other forms of under-nutrition.[11]
Stunting can be prevented by ensuring that adolescent girls and women before and during pregnancy as well as children under 2 receive adequate nutrition and hygiene [12] [13] [14] .
Relation to Sustainable Development Goals (SDG)
Stunting is included in SDG 2: “Zero hunger”, and it’s specific target: “By 2030, end all forms of malnutrition, including achieving, by 2025, the internationally agreed targets on stunting and wasting in children under 5 years of age, and address the nutritional needs of adolescent girls, pregnant and lactating women and older persons”.[15]
Illustration of Organizational Praxis
The Maternal and Child Survival Program (MCSP), a global USAID Cooperative Agreement supporting health intervention in 25 countries and with the goal of “ending preventable child and maternal deaths” [16] , works on preventing stunting through research and operations. One of the issues identified by MCSP is junk food consumption at an early age, since this food is commonly poor in nutrients and it is used to replace nutritious food [17] . In Egypt, for instance, a high consumption of junk food has caused both stunting and obesity among young children [18] . MSCP and its predecessor, Mother and Child Health Integrated Program (MCHIP), have conducted operations research around stunting and provided guidance for health providers and community workers to address the issue [19] .
Critique
Stunting is one of many indicators of nutritional status, and it should not be used as the only measurement but rather together with other indicators such as wasting, underweight, mid upper arm circumference or body mass index. When the circumstances that led to a person's stunted growth are known, it is easier to make an accurate assessment of their nutritional status, because stunted growth alone does not tell everything.[20]
Examples from Finland
Stunted growth is uncommon in Finland. When it occurs, the reasons behind it are disruptions at the fetal stage and the health of the mother during pregnancy. On top of poor nutrition, also smoking, heavy use of alcohol and drugs as well as diabetes and blood-pressure problems during pregnancy can cause disruptions in the child’s growth. [21]
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